The long-term mental health consequences of chronic stress have rarely been studied from an epidemiologic perspective. The accident at Three Mile Island (TMI) provided an opportunity to implement a longitudinal study of the mental health of recent mothers living near TMI and workers at the plant. Multi-wave data were also collected on nuclear and non-nuclear comparison groups. Analyses to date indicate that mothers of young children living near TMI continued to show elevated symptom levels thirty months after the accident; no differences were found among the workers. This proposal has two major goals: first, to continue to monitor the reactions of the respondents by conducting a telephone survey 5 1/2 years after the accident; second, to extend our analysis of the psychological effects of chronic stress. These analyses will focus on changes in mental health in relation to personal vulnerability, life stressors, social support, demographic characteristics and perceptions of the level of danger associated with problems at TMI. The results of these analyses will be evaluated in terms of their generalizability to mothers enduring another endemic stress, namely, unemployment. That is, after the third wave of interviews, unemployment rates began to soar in the comparison sites. This situation provides a natural experiment in which to cross-validate the results of analyses on the effects of persistent stress associated with TMI. Workers enduring chronic stress in the nuclear plants will also be a focus of analysis. Finally, predictors of poor psychological and school adjustment in the index children of the mothers cohort will also be studied with longitudinal data.